Monday, February 25, 2008

Bad News on the Election Front

For those looking for relief from the Obama-Clinton tiffs, I unfortunately have some bad news about the American Psychiatric Association election: Alan Schatzberg beat Donna Norris.

As I covered in a prior post, Norris heads the task force charged with scrutinizing the conflicts of interests of potential DSM-5 committee members. Schatzberg, on the other hand, is a great champion of industry-funded CME. He is on the clinical advisory board of "neuroscienceCME," a new MECC portal owned by CME Outfitters. This company produces a blizzard of CME in different formats, each funded by a single drug company whose product shines more brightly than its competitors in the neuroscienceCME version of reality. Schatzberg is also the editor-in-chief of the new journal, "The International Journal of Sleep and Wakefulness," which is produced by the MECC CECentral, funded entirely by Cephalon, and is a blatant full journal advertisement for Provigil. BUT WAIT, THERE'S MORE! Schatzberg is co-chair, along with star hired gun Charles Nemeroff, of a series of fancy CME meetings traveling across the country on behalf of Bristol-Myers Squibb and Otsuka, makers of Abilify. Entitled Current Concepts and Approaches in Treatment Resistant Depression, these meetings were created in order to highlight recent data showing that Abilify has some mild effectiveness as an augmenter of antidepressants.

But the election news was not all bad. David Fasslerwas elected as the secretary-treasurer and Dilip Jeste as trustee-at-large. Neither of them accepts industry money and Dr. Jeste made a conscious decision one year ago to sever his industry connections because of his concerns regarding industry influence.

Many editors of the larger psychiatric journals have financial involvements with the pharmaceutical industry. A prominent example is Joseph Coyle, editor-in-chief of Archives of General Psychiatry, arguably the most influential of all psych journals. Dr. Coyle's disclosures can be found here: http://www.medscape.com/viewarticle/546990.

As long there is full disclosure, this isn't necessarily a bad thing. I have no problem with Coyle, he has great scientific integrity and edits a great journal. My beef with Schatzberg is that he is happily involved in what I believe to be an inherently corrupt endeavor--commercially-funded CME.

Once again, I am proud to have renounced my APA membership 13 years ago. As long as gutless colleagues either look the other way or pat their "distinguished" peers on the back for another moment of 'the good ol' days', I realize how pathetic, and dare I risk saying the unthinkable, how corrupt my field has become.

For those of you who do care, take the risk and read "comfortably numb" by Charles Barber, a mental health care provider and active lecturer at Yale University School of Medicine. While recently a colleague called this tripe, the opinions of non-psychiatrists do and will continue to get more press and respect in the general media.

Every time you as a physician open your prescription pad five minutes after a patient sits down in front of you, I just have to ask, did you really go to an accredited Residency program? Pharmaceutical companies sure hope you didn't!!!

For all of you who did not rise and fight managed care when they forced us to relinquish psychotherapy as a treatment intervention back in the 90's, it's painfully similar to the way the Nazis murdered millions in WW2.The difference is us as physicians might as well be prescribing the poisons we will be taking down the road. Perhaps a harsh, if not outlandish analogy, but I feel it fits.

The Left cannot abide democratic decisions. The Left has no facts, so only personal attacks remain. The Left does not support freedom of speech, and seeks to censor opponents. The Left does not acknowledge its conflict of interest and it hypocrisy, in smearing direct competitors.

Although the APA is a horrid, anti-clinician, PC, foaming at the mouth, rabidly, left wing organization, its critics can be worse.

therapyfirst said:"For all of you who did not rise and fight managed care when they forced us to relinquish psychotherapy as a treatment intervention back in the 90's, it's painfully similar to the way the Nazis murdered millions in WW2."

Therapyfirst, comments like these diminish the memory of those murdered during World War II. Comparisons like yours with the events of the Holocaust and similar atrocities are rarely if ever justified.

My apologies to Dr Carlat for furthering a discussion in his blog that he did not incite, but to Dr Altus, I have two comments to your second blog statement:

1. I am Jewish, know of the atrocities from this terrible chapter in our history, and it seems to be well known that mental health patients were one of the first to be sacrificed for terrible causes. 2. As I said in by blog response,"perhaps a harsh, if not outlandish analogy..."; I feel strongly that the efforts of managed care, and to some equal degree by the pharmaceutical industry, resemble that of what was done by the German political system. It was first suggested by a lecturer at American University back around 1995. It's just my opinion, as you are entitled to yours. My advice is focus on Dr Carlat's blog issues.

I'd love to respond to Supremacy Claus's comments, but it is not the place here.

Again, my apologies to you Dr Carlat, but ignoring the inevitabilities supports the adage, "evil thrives when good men lie silent". Your efforts hopefully will prevent this.

How long has Fassler not been accepting industry money? He certainly is the "go to" person for the media anytime there's an issue with antidepressants and kids or anything like that. I always assumed he was an industry spokesperson. He certainly spouts the party line.

Therapyfirst: HMO's. Holocaust. No. That's a desecration of holy history.

It's called Godwin's Law. It reflects exhaustion of left wing argument. The facts deserted the Left 100 years ago.

http://en.wikipedia.org/wiki/Godwin's_law

There is also reductio ad Stalinum, ad Talibanum.

Feel free to reply to my points. This is the place. Carlat is a hopelessly biased, Left wing ideologue, a total victim of Harvard Hate America indoctrination. He will enjoy your arguments.

Carlat insults patients. He believes a patient has not responded to a treatment. The patient will permit a doctor to persist, so that the doctor can get a free pen or dinner. If he ever decides to see some patients, they can rebut that delusion in first 5 minutes.

Supremacy claus, To set the record straight, I do indeed see real patients, and I usually treat them with medications, because they often work. I'm not anti-pharma, or anti-medication, or anti-doctor. Just anti-deception.

Dan: We share basic values, 1) a belief in empiricism, and in what works for patients; 2) hypocrisy being a form of deception (hopefully, you include hypocrisy in your opposition); 3) some fairness to all parties in the health system, especially the sole reliable suppliers that find and make the tools of the doctor, the pharmaceutical companies.

What do you think of a supercilious medical school that forbids its residents from accepting a sandwich from a drug company. It fears that residents would prescribe promoted, but ineffective antibiotics to people in septic shock because of a sandwich.

It then requires that all funding by drug companies for CME's, research, etc. go through its administration, with the total amounting to $10's of millions a year. Those are the Ivy shops.

I want to hear your views of the ethics of the left wing hypocrite extremists, running the Ivy med schools.

I will gladly mail you a resume and personal information, but to a private email.

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About Dr. Carlat

I am a psychiatrist in Newburyport, Massachusetts and an Associate Clinical Professor of Psychiatry at Tufts Medical School (but note that the opinions expressed in this blog are not those of Tufts). I graduated from the psychiatric residency at Massachusetts General Hospital in 1995, and am the founder and publisher of three CME newsletters, including The Carlat Psychiatry Report. In March 2012, I left the publishing world to work on conflict of interest issues for The Pew Charitable Trusts, as director of the Pew Prescription Project. I returned to Newburyport and Carlat Publishing in September 2014.